HIV in Children

DIARRHEA IN AN HIV INFECTED CHILD (COMMUNITY MANAGEMENT)

Dr. Ira Shah
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Last Updated : 1st September 2012

Acute gastroenteritis


Diarrhea is quite common in HIV infected children. Dehydration is a common cause of mortality and morbidity. Thus one should assess dehydration and base management considering special types of diarrhea diseases. Rehydration should be based on WHO protocol and part of the IMNCI programme.
Children with severe dehydration should be referred to the hospital immediately.

Patients with following danger signs should be hospitalized:
  • Infants under 1 month of age
  • Malnourished children
  • Convulsions
  • Altered sensorium
  • Persistent vomiting
  • Respiratory distress
  • Persistent diarrhea with dehydration
  • Hypothermia
  • Abdominal distension
  • Dysentery in a child < 12 months of age.

Pre-referral treatment as per IMNCI including first dose of antibiotic and rehydration should be started prior to referral.

Dysentery


Dysentery presents with blood in stool with or without mucus.
Patient should be hospitalized if
  • Child is dehydrated
  • Child is less than 12 months of age
  • No improvement after 2 days of antibiotics
  • Child’s condition is worsening

Hospital management


  • Ceftriaxone – 100 mg/kg/day IV for 3 to 5 days in BD doses
  •                                 OR
      Amikacin – 15 mg/kg/day IV for 3 to 5 day in BD doses

Out-patient management


Antibiotics as per IMCI programme and correction of dehydration.
  • Educate family on hygiene
  • Send stools for microscopy and culture.

DIARRHEA IN AN HIV INFECTED CHILD (COMMUNITY MANAGEMENT)
Dr. Ira Shah
Incharge Pediatric HIV and TB Clinic, B.J.Wadia Hospital for Children, Mumbai, India Consultant in Pediatric Infectious Diseases, Nanavati Hospital, Mumbai, India.
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